Local Administration of Antibiotics by Gentamycin-Collagene Sponge does not Improve Wound Healing or Reduce Recurrence Rate after Pilonidal Excision with Primary Suture. A Prospective Randomized Controlled Trial

摘要

Poor old sacrococcygeal pilonidal sinus is an orphan disease; it has no society or annual meeting on some distant palm-fringed shores. This is bread-and-butter general surgery, without the flashing lights of robotics or the glamorous reps of stapler manufacturers. Perhaps because of this, there are few well-designed, properly powered, randomized, controlled trials of treatments for pilonidal sinus. Roland Andersson and his colleagues are to be congratulated for completing their multicenter, randomized, controlled trial of the use of Collatemp (gentamicin-impregnated collagen sponge) as an adjunct to excision and primary closure of pilonidal sinus. They found that the use of Collatemp did not reduce wound complications or recurrence rate after pilonidal sinus surgery. They also have demonstrated that surgeons working in cooperation with colleagues in different hospitals can together perform good randomized, controlled trials with rapid patient accrual. This collaborative approach is a model that others would do well to copy.